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A  Controller  of  the  Tongue  and 

Palate  During  General 

Anesthesia 


JOSEPH     E.     LUMBARD,     M.D. 

Instructor    in    Anesthesia,    University    and    Bellevue    Hospital     Medical 

College;    Anesthetist    to    Harlem,    Knickerbocker 

and    Lying-in    Hospitals 

NEW     YORK 


A    CONTROLLER    OF    THE    TONGUE    AND    PALATE 
DURING     GENERAL    ANESTHESIA* 


Joseph  E.  Lumbard,  M.D.,  New  York 

Instructor    in    Anesthesia,    University    and    Bellevue    Hospital    Medical 

College;     Anesthetist     to    Harlem,     Knickerbocker    and 

Lying-in  Hospitals 


It  is  of  great  importance  to  maintain  an  unobstructed  air 
way  during  the  administration  of  a  general  anesthetic.  The 
prevention  of  obstruction  to  free  breathing  through  the  upper 
air  passages  is  one  of  the  most  important  details  with  which 
the  anesthetist  has  to  cope.  The  most  common'  form  of 
respiratory  obstruction,  during  anesthesia,  is  the  falling  back 
of  the  tongue  into  the  pharynx,  owing  to  the  relaxation  of  the 
muscular  support. 

There  are  several  instruments  to  overcome  this  difficulty, 
known  as  air  ways,  breathing  and  pharyngeal  tubes.  Those 
best  known  are  the  tubes  devised  by  Hewitt  of  London  and 


Lumbard's  controller  of  the  tongue  and  palate  for  general  anesthesia, 
thirteen-twentieths   actual    size.     The  pharyngeal   end    is  at  the   left. 


Connell  of  New  York.  Both  give  excellent  results,  but  are 
open  to  the  great  objection  of  becoming  obstructed  with 
mucus. 

To  overcome' this  I  have  devised  an  instrument  which  con- 
sists essentially  of  a  double  row  of  four  bent  wires,  running 
parallel,  about  an  eighth  of  an  inch  apart,  and  firmly  held 
together  by  wire  bands,  two  at  each  end.  The  instrument 
measures  5^4  inches  in  length,  three-fourths  inch  in  width 
and  one-fourth  inch  in  thickness  :  It  presents  a  double  curve 
which  adapts  itself  to  the  dorsum  of  the  tongue.  The  instru- 
ment is  easily  introduced,  by  placing  the  pharyngeal  end 
between  the  tongue  and  the  soft  palate,  until  it  rests  in  the 
pharynx.      No   attempt   should  be  made  to   do  this   until  the 

*  Shown   at   the   New   York   Academy    of   Medicine    (Section   on    Sur- 
gery),   March   S,    1915. 


patient  is  well  anesthetized.  The  use  of  the  instrument  is 
also  indicated  in  obstructions  of.  the  nose  and  mouth.  It 
obviates  the  barbarous  methods  of  tongue  retraction  and 
jaw  holding,  and  an  instrument  of  this  nature  should  be 
considered  as  an  essential  part  of  every  anesthetist's  outfit. 

ADVANTAGES 

1.  It  is   easily  and  quickly   introduced.     No  mouth-gag  or 
manipulating  of  the  tongue  are  necessary. 

2.  It  will  not  clog  with  mucus,  which  is  the  chief  defect  of 
similar  instruments. 

3.  It  is  easily  kept  in  position. 

4.  It  is  quickly  cleansed. 

5.  It  will  not  conduct  a  fluid  anesthetic  to  the  throat,  an 
accident  that  is  liable  to  occur  with  other  instruments. 

6.  It  cannot  be  compressed  by  the  teeth  or  gums. 

I  wish  to  thank  Dr.  W.  H.  Luckett  for  his  valuable  sug- 
gestions in  developing  this  instrument. 

1925  Seventh  Avenue. 


Reprinted    from     The    Journal    of    the    American    Medical    Association 
May   22.    1915,    Vol.    LXIV,   />.    1757 


Copyright,  1915 
American  Medical  Association,  535  N.  Dearborn  St.,  Chicago 


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